May 9, 2005 -- -- More than half of Americans live with chronic or recurrent pain, with broad numbers saying it interferes with their activities, mood and enjoyment of life -- sparking a vast search for relief, from medication to bed rest, yoga or the palliative power of prayer.
An exclusive survey by ABC News, USA Today and the Stanford University Medical Center finds that, excluding minor annoyances, just under half of adults have experienced pain in the last two weeks, and nearly four in 10 do so on a regular basis.
Six in 10 Americans rate their last experience with pain as moderate or worse, and for two in 10 -- about 40 million individuals -- it was severe. Nineteen percent suffer chronic pain, meaning ongoing pain that's lasted three months or more. An additional 34 percent report recurrent pain; the rest say their usual pain experience is acute, or short-term.
This national survey paints an extensive portrait of pain in America, measuring not just prevalence and severity but also where it hurts (back and knee pain are most common), whom it effects (pain is much more frequent among older adults), and its source, impact and treatment. The survey supports a weeklong reporting project by ABC News and USA Today, "The Fight Against Pain."
Pain impacts are broad: Sufferers are less likely than other Americans to be very satisfied with their lives overall, and much more likely to say they're in bad health. About four in 10 Americans say pain interferes with their mood, activities, sleep, ability to do work or enjoyment of life. Two-thirds report interference with any one of these.
Sizable majorities of those who've tried various relief therapies report that they work at least somewhat well -- ranging from medications to heating pads or ice packs to less prevalent methods such as massage therapy, seeing a chiropractor, or homeopathic and herbal remedies. But many fewer say any of these work "very well." Even prescription drugs fall short: While six in 10 Americans have taken prescription drugs for pain, just 51 percent of them say such medications have worked very well.
Concerns about the efficacy of treatment also are reflected in assessments of medical care. Sixty-three percent of Americans have spoken with a doctor or other medical professional about their pain. But while nine in 10 say the doctor understood the problem, many fewer, 59 percent, say they got a great deal or good amount of pain relief. And fewer still, just 31 percent, report a "great deal" of relief.
Similarly, while eight in 10 report at least some control over their pain, fewer -- half -- feel they have "a lot" of control.
Problems peak in the chronic, severe and frequent pain populations. People in these high-pain groups are vastly more likely than others to report negative impacts of pain on their lives, and much less likely to feel in control of their pain. (These hold true even when controlled for age.)
People with chronic pain also are more likely than others to have tried various remedies -- but much less likely to say those remedies work very well.
Chronic or frequent pain sufferers are much more apt to have spoken with a doctor or other health professional about the problem -- about 90 percent have. But, again, they're less likely to have gotten relief: Just 48 percent of frequent pain sufferers, and 50 percent of those with chronic pain, say they got at least a good amount of relief after seeing a medical professional. Relief rates are higher -- 66 percent and 68 percent, respectively -- among infrequent or acute pain sufferers who sought professional care.
There's other evidence that doctors do better dealing with acute pain than with more persistent pain problems. Among acute pain patients, 79 percent say the doctor understood their problem very well. Fewer chronic pain patients, 63 percent, say so.
Nearly six in 10 Americans, 58 percent, say they've tried prayer to deal with pain, about as many as have taken prescription drugs. And of those who've tried it, half say prayer has worked very well for them in terms of pain relief -- tying it with prescription drugs as the top-ranked approach for efficacy.
While prayer is clearly a source of comfort to many in pain, it's not a replacement for other therapies. People who've prayed for pain relief are more apt than others also to take prescription drugs for pain; to have tried other pain therapies; to have seen a doctor for pain; and to report chronic, severe or frequent pain. Prayer thus looks like an additional approach for those with greater pain problems, rather than a replacement.
And as with other remedies, prayer works best on easier problems. Among people with acute pain, 61 percent say praying for relief worked very well for them; among those with chronic pain, many fewer, 37 percent, say prayer works.
Women are more apt than men to have prayed for pain relief: Sixty-six percent of women have done it (62 percent of women under 50, rising to 71 percent of women age 50 and over). That compares with 49 percent of men (with no difference by age). Praying also is most prevalent among blacks, and in the South.
A quarter of Americans say their last pain experience was with back pain, making it far and away the leading area of pain, followed by pain in the knee (12 percent), headaches or migraine (9 percent), and shoulder and leg pain (7 percent each.) Together these account for 60 percent of all pain by location.
Back pain is No. 1 across most demographic groups, with the notable exception of women under age 50. It peaks among men (30 percent say their last pain experience was back pain, compared with 20 percent of women), and particularly among men age 30-49, who may run the dual risk of being a bit older but still quite active. Back pain is the most-cited pain across all pain groups, peaking slightly among chronic pain sufferers.
Women younger than 50 are an exception: They're as likely to cite headache or migraine (20 percent) as back pain (18 percent) as their last pain experience. At age 50 and up, back pain leads for both sexes.
Half of Americans say their pain is the result of a specific medical condition or injury; among these, the most common sources of pain by far are injury or accident, including broken bones, back and muscle pain and sports injury (20 percent in and of itself); arthritis follows (9 percent). Chronic and frequent pain sufferers are much more apt than others to cite a specific injury or condition -- about two-thirds in these groups do.
Causes of pain vary in specific groups, most notably by age. Seniors who cite a specific ailment or injury are far more apt to say it's arthritis, 32 percent, and, naturally, far less likely to say it's a sports injury (8 percent). Sports injuries jump among men under 50 (31 percent), and soar among younger men. Among those under 30 who cite a specific cause of their most recent pain, 53 percent say it's a sports injury.
As noted, there are sharp differences in the prevalence and nature of pain by age. Fifty-seven percent of seniors experience pain often, compared with just 17 percent of adults under 30 (it's more stable across the middle ages, at 43 percent).
Chronic pain is exceedingly rare among young adults -- just 3 percent of those under 30 report it. Instead they're most apt by far to report acute or specific injury-related pain -- seven in 10 young adults say their last pain experience was acute. Their elders (and not just senior citizens, but also those in their 30s through 50s) are much more likely to report recurrent or chronic pain.
Age 50 looks to be one breaking point for pain: Four in 10 people who are 50 and older say they've had a pain episode in just the last few days. Among those younger than 50, that drops to about a quarter.
Averages also describe these age differences: The average age of acute pain sufferers is 39; that jumps to 48 for people with recurrent pain, and 53 for those with chronic pain. Similarly, people who "hardly ever" experience pain are 40 years old on average; those who experience it very often have an average age of 52.
There are fewer differences among age groups when it comes to severity. Adults under 30 are least likely to report that their last pain experience was severe at its worst; 13 percent do so. But it's about the same among middle-aged adults and seniors, 23 percent and 24 percent, respectively.
Men and women have equal frequency of pain, and are equally likely to rate it as mild, moderate or severe; however, when a 0-10 number scale is used, women are 11 points more likely than men to rate their last pain experience at seven or higher, 33 percent to 22 percent. Men are more apt to have acute pain; women to have recurrent pain. Women are more apt to have spoken with their doctor about pain, and also somewhat more likely to say it interferes with their mood, sleep, enjoyment of life, and ability to work or do chores.
Over-the-counter-drugs and home remedies (heating pads, ice packs, hot baths or showers) are the most commonly used pain therapies among all Americans, with more than eight in 10 having tried them. About six in 10 have used prescription drugs, bed rest or, as noted, prayer.
There's a sharp drop-off in the prevalence of other approaches. Just under three in 10 have tried massage therapy or visiting a chiropractor; about 15 percent have tried homeopathic or herbal remedies, or yoga or meditation. Twelve percent have tried drinking alcohol to ease pain (twice as many men as women), 6 percent smoking marijuana, and 5 percent acupuncture.
The efficacy of any of these may leave something to be desired. Best-rated are prescription drugs and prayer, with 51 percent saying each of those worked very well. Just over four in 10 say massage therapy and chiropractic care worked very well for their pain.
Fewer -- about a third in each case -- say over-the-counter drugs, bed rest or yoga worked very well to ease their pain, and it was closer to one-quarter for home remedies or homeopathic or herbal remedies. Last on the list for efficacy was drinking alcohol; just 18 percent said it worked well. (The sample of people who've tried marijuana or acupuncture for pain is too small for reliable analysis of how well it works.)
There are differences among pain populations. In their search for relief, chronic pain sufferers are more likely to have tried, in particular, prescription drugs (80 percent) and massage therapy (42 percent), as well as prayer (69 percent). But they're much less likely than others to say these have worked very well. For example, just 30 percent of people with chronic pain say prescription drugs have worked very well for them, compared with 64 percent of those with acute pain.
While 60 percent of adults have tried prescription drugs for pain, most, two-thirds, take them infrequently. Still, 19 percent take such drugs on a daily basis, and an additional 15 percent either weekly or a few times a month. Daily use of prescription drug soars to 44 percent of those with chronic pain.
Just over a quarter of those who've taken pain medications -- either prescription or non-prescription -- express concern about the possibility of serious health risks from these drugs. And that concern spikes to 39 percent of daily drug users.
Recent government action on some medications may be fueling those concerns. Seventy-five percent in this survey say that, given what they know, the Food and Drug Administration was justified in its recent actions on Bextra and Vioxx (now off the market), and its requirement of new warning labels on Celebrex and drugs containing naproxen, such as Aleve.
Fifteen percent overall (and 37 percent of those with chronic pain) say they've taken Vioxx or Bextra; of them, 12 percent say they've experienced self-defined "serious negative side effects." Eighty-five percent say they wouldn't take those drugs again.
The numbers on usage and self-reported side effects numbers are very similar for Celebrex; while it's still on the market, 61 percent say they wouldn't take it again. Far more say they've taken naproxen-containing drugs such as Aleve (six in 10); unlike the others, these are sold over the counter. Fewer of them, 6 percent, report any serious side effects, and 62 percent say they'd take such medications again.
This ABC News/USA Today/Stanford University Medical Center poll was conducted by telephone April 13-19, 2005, among a random national sample of 1,204 adults. The results have a three-point error margin. Sampling, data collection and tabulation by TNS Intersearch of Horsham, Pa.
A leading specialist in pain assessment, Dr. Charles S. Cleeland, chair of the Department of Symptom Research and McCullough Professor of Cancer Research at the University of Texas M.D. Anderson Cancer Center, Houston, assisted in the questionnaire design for this survey.
You can find more ABC News polls in our Poll Vault.